Provider Demographics
NPI:1306854039
Name:DAGHER, SAMI I (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMI
Middle Name:I
Last Name:DAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6514
Mailing Address - Country:US
Mailing Address - Phone:561-733-8133
Mailing Address - Fax:561-733-6670
Practice Address - Street 1:2401 S SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6514
Practice Address - Country:US
Practice Address - Phone:561-733-8133
Practice Address - Fax:561-733-6670
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60257208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650664702OtherTIN
FLG19968Medicare UPIN
FL650664702OtherTIN